Provider Demographics
NPI:1376008771
Name:REED, COREY B (LMFT)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:B
Last Name:REED
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1344 N PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67212-4229
Mailing Address - Country:US
Mailing Address - Phone:316-393-6750
Mailing Address - Fax:
Practice Address - Street 1:1600 N LORRAINE ST STE 202
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5600
Practice Address - Country:US
Practice Address - Phone:620-663-7595
Practice Address - Fax:620-513-5098
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-10
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2363106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist